Verona A. Lodholz, DC, MT(ASCP), CPC, CCDS, review various laboratory sections and case studies, including hematology, coagulation, transfusion services, chemistry, and microbiology.
Kimberly A. H. Baker, JD, CPC, demystifies the quality provisions that affect hospital payment, with a focus on understanding how the provisions operate and the actual dollar impact they have on payment at a hospital.
Kyra E. Brown, RHIA, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer, addresses issues that lead to high complication rates and will focus on documentation tips to assist in physician, coding, and CDI staff education and promote accurate complication rates.
Trey A. La Charité, MD; Lynn H. Lowery, CPC, CFPC, explore how healthcare reform is rapidly changing to reimburse providers for outcomes of care as opposed to fee for service and how primary care physicians need to be the focus of your CDI efforts in the outpatient setting.
Mark Michelman, MD, MBA, provides strategies to handle prepayment reviews--a CMS, eight state
pilot that allows fiscal intermediaries up to 60 days to review a claim for payment.
Adele L. Towers, MD, MPH, FACP, discusses the effectiveness of an automated CDI process in risk adjustment coding and best methods to leverage CDI expertise to manage automated processes and network flows that will greatly improve coding documentation.
Sarah C. Mendiola, Esq., LPN, CPC, presents actual examples of costly denials that could have been prevented with CDIS intervention. These include 2-midnight rule denials, medical necessity for major joint replacement (as outlined by CMS), and justification of MCCs that are difficult to support...
Amy R. Herndon, RN, BSN, CCDS; Dawn R. LaRoque, RN, BSN, CCDS, CPHQ tools needed to implement a concurrent core measures program, allowing you the opportunity to intervene and avoid “misses,” and more importantly ensure that your patients receive the best care at the right time.
Allison Q. Clerval, RN, BSN, CCDS; Kathleen M. Shindle, RN, BSN, CCDS, share how Thomas Jefferson University Hospital utilizes the University HealthCare Consortium (UHC) risk model variables to benchmark patient outcomes and accurately reflect expected patient mortality.
